ABSTRACT
OBJECTIVE: The objective of this paper is to compare the hormonal changes and sexual activity between transplanted patients and patients in regular haemodialysis (HD). MATERIAL AND METHODS: 130 patients, 98 RT carriers and 32 with CRF were evaluated with regard to the sexual function. The etiology of CRF is similar in both groups. All patients underwent hormonal determinations (FSH, LH, Prolactin, Testosterone, Oestradiol and PTH), complete serum testing and other diagnostic studies done selectively, 38 of 130 patients (14 in HD and 24 transplants) answered a personal questionnaire on sexual activity. RESULTS: Oestradiol and prolactin levels are higher in the HD group compared to transplanted patients (p < 0.05). 70% of RT patients maintain their libido versus 35% of those in dialysis (p < 0.01). The former group refers good erection in 55% cases versus 21% of dialysis patients (p < 0.01). Intercourse frequency and degree of overall satisfaction is higher in the RT group (N.S.). CONCLUSIONS: No significant differences were found in FSH, LH and testosterone levels. The normality of FSH levels may be a reflection of the integrity of the germinal line. 65% HD patients refer decreased or absent libido, to which the higher levels of prolactin and oestradiol found could contribute. No relationship was found between sexual function with the type of immunosuppression or the graft function.
Subject(s)
Endocrine System Diseases/etiology , Erectile Dysfunction/etiology , Kidney Failure, Chronic/complications , Kidney Transplantation/adverse effects , Adult , Humans , Male , Middle Aged , Renal DialysisABSTRACT
A total of 51 potential recipients of a renal transplant (RT) have been evaluated with an Eco-Doppler study of the posterior femoral, popliteal and posterior tibial corteries. Acceleration (AC), mean rate (MR), maximum systolic rate (MXSR) and minimal diastolic rate (MNDR), as well as pulsatility (PI) and resistance index (RI) were measured. Arterial high blood pressure (HBP), smoking, time in haemodialysis (HD) and cholesterol and triglycerides levels, were evaluated as vascular risk factors. RI and PI were maximal, and MXSR, MR and AC minimal at the popliteal artery level. Smoking (number of cigarettes/day) (R = 0.77), systolic blood pressure (BP) (R = 0.43), time of HBP evolution (R = 0.044), cholesterol level (R = 0.43) and time in HD (R = 0.35) correlate with Eco-Doppler parameters. Fifteen of these 51 patients underwent transplantation, and increased RR and PR with decreased MR and MXSR were seen post-RT in the ipsilateral popliteal and posterior tibial arteries. Eco-Doppler is a useful technique to evaluate the vascular risk of potential RT recipients.
Subject(s)
Kidney Transplantation , Preoperative Care/methods , Ultrasonography, Doppler , Adult , Humans , Middle Aged , Risk Factors , Vascular Diseases/diagnostic imaging , Vascular Diseases/physiopathologyABSTRACT
A total of 118 allograft nephrectomies (TX) were performed after 474 renal transplants (TR) (24.9%). 49.1% of the patients were immunosuppressed with azathioprine-prednisone (AZA-PRED) and 50.9% with cyclosporine-prednisone (CSA-PRED). Mean time to TX after returning to hemodialysis was 36.2 +/- 6.4 days (0-372). Acute rejection (33.1%) was the first cause of TX, followed by chronic rejection (26.3%), vascular complications (25.5%), recurrent renal disease (5.9%), non-functioning allograft (4.2%) and not clearly established cause (1.7%). The surgical technique was extracapsular in 70.3% of the cases and subcapsular in 29.7%. The mean post-TR time to TX was significantly greater (p < 0.01) for the subcapsular technique. The mean surgical time was 106 +/- 4.4 min (45-300). Post-TX morbidity was 34%. Hemorrhage (11.2%) was the most frequent complication. The rest of the complications were infection (10.4%), neurologic (5.4%), gastrointestinal (4.5%), pulmonary (3.6%), cardiovascular (2.7%), nerve lesions (2.7%), lymphocele (0.9%) and urinary fistula (0.9%). The post-TX mortality was 6.5% (7/118), although it was significantly lower in the patients immunosuppressed with CSA-PRED (1.6%) than in those treated with AZA-PRED (10.3%).
